Training for In-Home Caregivers Cuts Hospitalization Rates

When in-home caregivers participate in intensive training, their patients are less likely to go to the emergency room or be hospitalized, according to a recent case study conducted in California.

In fact, the rate of repeated emergency room visits among patients cared for by trained workers dropped by 24% in the first year after undergoing an intensive training program, and by 41% in the second year, according to an analysis by researchers at the University of California-San Francisco. As part of a pilot program carried out in Los Angeles, San Bernardino and Contra Costa counties, almost 6,000 aides were trained in CPR and first-aid, along with infection control, medications, chronic diseases and other areas. All were workers of the In-Home Supportive Services (IHSS) program, who are paid by the state to care for low-income seniors and people with disabilities.

Researchers then based their analysis on the results from Contra Costa County, which they said produced the most complete and reliable data. They compared insurance claims on 136 at-risk elderly and disabled residents whose caregivers had been trained to the claims of more than 2,000 similar residents whose caregivers hadn’t been trained.

Despite the small sample size, UCSF professor emeritus Bob Newcomer found the analysis encouraging.

“Training shows a lot of promise,” he said.

Currently, there are no federal training requirements for in-home caregivers, according to California Healthline. Even so, training programs have been developed and tested across the country, according to the Paraprofessional Healthcare Institute, an advocacy group that provides training. Massachusetts, North Carolina and Michigan have attempted to implement different types of instruction, for example.

Workers who participated in California’s pilot program and analysis were trained through the California Long-Term Care Education Center as part of a three-year, $11.8-million grant from the Centers for Medicare & Medicaid Services. Those who participated across the three counties attended about 60 hours of classes and completed 13 hours of related work at home, and the people they cared for also took part in some classes.

Beyond the effect on patients, training had a profound impact on caregivers, as they said they felt prepared to handle their jobs and communicate with their patients and doctors, according to the analysis. For example, Andrew O’Bryan cares for his 67-year-old mom in Contra Costa County, and he said she has diabetes, congestive heart failure, arthritis and high blood pressure. The training gave him the skills to conduct CPR in case of an emergency, and instilled a sense of when his mother needs to go to the hospital.

“Now I am more equipped to spot things” before they get worse, he said.

Written by Kourtney Liepelt